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For months now, the B.C. government has been confronted with arguably the most pressing and complex issue it has faced in years: a critical shortage of family doctors.

Nearly a million people in a province of a little more than five million are without a family physician. That statistic is responsible for a host of ancillary issues, including emergency rooms filling up with non-emergency health concerns. Meantime, others with no access to a doctor ignore their problems until they progress to a stage requiring expensive hospitalization.

Of course, this has not just been a West Coast phenomenon – it is a national crisis.

This week, the B.C. government unveiled a not-so-unique plan to both entice more doctors to the province and encourage more medical students to go into family practice upon graduation: offer scads of cash.

Yes, doctors in B.C. will soon be getting the kind of raise of which most of us can only dream. A full-time physician working 1,680 hours a year, who sees an average of 1,250 patients and has 5,000 patient visits, will earn at least $385,000. That compares with the $250,000 doctors now receive under the existing fee-for-service agreement. In other words, a 54-per-cent pay raise.

There will also be no cap on the number of patients a physician can see in a day; see more patients, see more money on your paycheque. And instead of being paid between $30 and $40 for a patient visit – a system that might favour booking in more appointments at the expense of addressing more time-consuming or complex patient problems – doctors will now be paid based on time spent with the person in their examining room.

B.C. Health Minister Adrian Dix estimated that the new fee model will cost taxpayers about $708-million over the three-year life of the agreement. And this is in addition to costs related to an earlier announcement to entice medical students who plan to become family physicians to practice in the province. Those incentives include a student loan forgiveness program and a $25,000 signing bonus.

The latest agreement with B.C. doctors is likely to have national repercussions, none more so than in neighbouring Alberta.

B.C. doctors are among the lowest-paid in the country. Soon, they will be among the highest, drawing significantly closer to the pay rates in Alberta, which on average are the highest in Canada. Physicians there may soon begin casting an eye westward, especially given the war Premier Danielle Smith has declared on the health care system, vowing to reorganize it in a manner which she deems fit.

She has also said she will not impose any future masking or vaccine mandates – an edict that many in the health care profession are against, especially as concerns rise elsewhere in the country over a fresh surge of COVID-19 infections causing critical-care bed shortages.

Ms. Smith has also shown enthusiasm for pseudo-science and bizarre theories. She has said, for instance, that cancer is preventable and within a person’s control until it reaches Stage 4 levels. (The public outrage sparked by her comments prompted Ms. Smith to walk back her remarks.) On a podcast she hosted before becoming the leader of the United Conservative Party, she offered a platform to a doctor who suggested the pandemic was “the greatest hoax ever perpetrated.”

Ms. Smith’s predecessor, Jason Kenney, was at war with Alberta doctors for much of his tenure, ripping up their master agreement shortly after taking office.

Given that backdrop, you can understand why maybe, just maybe, some doctors in the province might be considering a move to a more welcoming jurisdiction.

But it won’t be just Alberta doctors who will be investigating this deal – it will be their counterparts in other provinces as well. Family doctors in Ontario, for instance, made an average of $303,000 annually in 2019, according to the Canadian Institute for Health Information. Why wouldn’t some of them, especially those just starting out in their practices, take a look at what British Columbia is offering?

B.C.’s new deal could have another important effect: It could lure physicians who choose to practice in a hospital (where they have no overhead costs) to either return to a family practice setting or give it a try for the first time. The province, in fact, doesn’t necessarily have a shortage of doctors – it’s just that a sizeable chunk of them choose to work in hospitals because it’s more lucrative.

Or at least it was.

As our society ages, and there is an ever-increasing demand on our health care system, we are likely to see more of this type of pricey deal. There is a shortage of nurses as well, along with other specialists our health care system desperately relies on.

In many respects, they now have governments over a barrel.

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